This application proposes use of the NIA Academic Career Leadership Award to link renowned aging related programs at the New York Hospital- Cornell University Medical College by pairing the research methodology expertise of the candidate. Mark Lachs MD, MPH, a geriatrician, clinical epidemiologist, and health services researcher, with that of other gerontology program faculty in the mentorship of a fellow or junior faculty member in specific research projects for each year of the award. The newly appointed Chief of the Division of Geriatrics and Gerontology at the Medical College, Dr. Lachs has laid the foundation for leveraging Cornell's existing resources in the areas of geriatric medicine, psychiatry, mobility, sociology, and neurology in a way that will efficiently expand the aging research and training capabilities of the institution consistent with the goals of the RFA. These remarkable resources include: (1) An NIMH Research Center Grant on Mood Disorders under the direction of Dr. George Alexopoulos, (2) A NIAMS Multipurpose Arthritis and Musculoskeletal Disease Center Grant headed by Dr. Steven Paget, Chief of Rheumatology at Cornell and Physician-in-Chief of the Hospital for Special Surgery, (3) An NIA Roybal Social Gerontology Center Grant based at the Cornell Applied Geriatrics Research Institute headed by Dr. Karl Pillemer (the candidate's long-standing collaborator in studies of family violence committed against the elderly), (4) The Cornell Neurogeriatrics Program at Cornell Medical College and the Hebrew Home for the Aged in Riverdale, headed by Drs. Fred Plum and Norman Relkin, and (5) an AHCPR funded training program for physicians leading to a masters degree in clinical epidemiology and health services research from the Cornell's Graduate School of the Medical Sciences, headed by Drs. Mary Charlson and Pamela Williams-Russo, and on which the candidate serves as faculty. Additionally, in the spring of 1998, the institution will open the Irving Sherwood Wright Center on Aging, a 15,000 square foot community- based aging center, named in honor of pioneer in aging research and Cornell Professor Emeritus Irving Wright. A sample pilot project for year one is provided, the specific aim of which is to estimate the incidence of new or worsening depressive symptomatology and cognitive impairment in a group of "self-neglecting" older adults referred to adult protective services and who have been followed for over a decade as part of the New Haven EPESE cohort. This project pairs the candidate with two members of the geropsychiatry program (Dr. Martha Bruce, a Psychosocial Epidemiologist, and Dr. Robert Abrams, a geriatric psychiatrist with expertise in late life personality disorders) in the mentorship of Dr. Denis Keohane, a new faculty member in the Division of Geriatrics and Gerontology who has a scientific interest in prognostication in medical illness and a clinical interest in the homebound elderly.